More than a placebo effect?

Music nowadays is not only a food for the soul. It has also become a kind of food for the body as well, though this will not come as news to Nabila Mikhail, a professor of musical education and music therapy at Helwan University and a member of the World Federation for Music Therapy.

Mikhail discovered ways in which listening to music could help patients with high blood pressure back in the 1970s, when she presented her findings at various international conferences and received praise for her approach to music therapy.

However, the use of music to treat bodily ailments goes back a lot further than the 1970s. According to Mikhail's book Music Therapy, the ancient Egyptians, Chinese and Hindus all used music for therapeutic purposes, as did the ancient Greeks, Romans, Copts and Arabs.

Music therapy was also used during World War II, when Hans Hoff, head of the psychological diseases department at Vienna University Hospital in Austria, established the idea that music and medicine could go together and led cooperation between doctors, psychiatrists, musicians and teachers. Music therapy has been developing ever since.

Mikhail herself once dreamt of joining the Faculty of Medicine, but she was put off because traditional ideas held that it was a source of "shame for girls to join the workforce at that time."

Her father wanted her to choose an easier education, so she chose music, though music turned out to lead her back to medicine and her old dream of becoming a doctor. Mikhail read about music therapy in a newspaper and then started conducting her own research, choosing it as the subject of her Masters degree. "I experimented with blood pressure patients at Qasr Al-Aini Hospital, because blood pressure can be measured," Mikhail explained.

She looked for ways in which music could affect blood pressure and found that listening to soft music could help a patient to relax, helping to decrease blood pressure. Listening to music for one and half hours could equal six days of medications, she found.

Mikhail explains that listening to relaxing music helps the body to relax, including the arteries. This helps blood flow, decreasing high blood pressure. Music can also affect the level of cortisone in the blood, she says.

"Music has no side effects, unlike medications. It is my hope that some patients will benefit from listening to music rather than getting drugs from pharmacies," said Mikhail, though she admits that her approach cannot work with all diseases.

Patients suffering from high blood pressure could benefit from listening to music that is played on a single instrument, such as flute music. It should be non-rhythmical. If on the other hand a patient has low blood pressure, he could benefit from listening to more rhythmical music.

In her book, Mikhail says that listening to soft music can enhance happiness, helping to activate the digestive system. Music can also help with paralysis or agitation, she says.

According to Ramez Mustafa, a lecturer in neurology and psychiatry at Ain Shams University in Cairo, though music can be used for pain and psychological treatment, it does not cure disease.

"It could be beneficial in mild cases, and it is better than medicine in the sense that it does not have side effects," he said. "However, intractable psychological cases, such as cases of schizophrenia, must be treated with drugs. Depression, for example, could be helped by listening to music, but this is not the case for more serious illnesses."

Music could, however, improve mood and activate chemicals in the brain that are associated with happiness, especially if the music is associated with memories.

Mikhail adds that asthma could be treated with music. Asthma patients suffer from a narrowing of the bronchial tubes, and they are often not able to attain a normal rate of breathing, which equals a four-beat pulse. Such patients could be helped by listening to music with a similar pulse: breathing and heart beat could thus interact with the music, with the heart beat coming into line with the four beats of the music.

Music can also be used to reach unborn infants in the womb, but despite its benefits Mikhail states that music therapy, while used abroad, is not widely practised in Egypt.

Two years ago, she introduced it into the curriculum at her university for postgraduate students, also introducing undergraduate modules, though Mustafa says that at his university, Ain Shams, music therapy is only briefly taught to postgraduate psychology students.

Music can assist in treatment, but it is not in itself a form of medical treatment, he says, though he readily admits that music therapy can be used in treating addiction, anxiety and depression. At Ain Shams University Medical Centre it is probably underutilised, he adds.

According to Mikhail, Ibrahim Badran, minister of health from 1976 to 1978, had plans to include music therapy in the treatments used in Egyptian hospitals. However, this did not take place because Badran changed jobs. When Mikhail approached other ministers later, none of them replied, she says.

Could music also have deleterious effects?

According to one website selling music, the music it sells can simulate the effects of illegal drugs and enhance the senses. Users should listen to the music through headphones, relax in bed, lower the light, and close their eyes.

Mustafa, who has listened to the music the site sells, says that it is similar to white noise, which has been used to treat patients in more formal environments, including for anxiety. The site's version changes in tone and frequency, and listening to it for extended periods can affect the brain and feelings of happiness, altering sleep patterns and sexual desire, the site claims.

Mustafa commented that this was possible theoretically, since "some types of music, or sounds with specific frequencies, could change brain chemistry, affecting attitudes and feelings. However, proving that this is the case scientifically would take a huge effort, and this has not yet been done."

Samah Zohair, a nutritionist and homeopath, has looked into music therapy from a different angle, commenting that in her view all bodily organs, including cells and tissues, have a special "frequency". This might be measured, with a view to finding out whether organs are functioning normally or not.

In Zohair's view, the brain's different centres could be affected by sounds of different frequencies, and listening to certain sounds could stimulate those centres.

Some users of the music sold by the website said that the music had strongly affected them, though others mocked the whole idea. Mustafa thinks that some people may get more stimulation from sound than others. "Like music played in restaurants, not everyone will be affected by it."

Another reason for the music's occasional effect could be due to the placebo effect, in which even sugar pills can affect certain patients. "In a way, the pills do affect them because they believe that the pills will improve their condition, and so they do," Mustafa says.

The same thing may be true for those who believe in the medical power of music.